Provider Demographics
NPI:1518697341
Name:UNITED PROVIDERS OF HEALTH
Entity Type:Organization
Organization Name:UNITED PROVIDERS OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-400-0718
Mailing Address - Street 1:9650 STRICKLAND RD # 103-189
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1902
Mailing Address - Country:US
Mailing Address - Phone:919-701-6603
Mailing Address - Fax:
Practice Address - Street 1:108 E ANDREWS ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:NC
Practice Address - Zip Code:27812-7100
Practice Address - Country:US
Practice Address - Phone:919-701-6603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty